A few weeks ago during class, Andrew was discussing the discovery of the effects of cigarette use on the likelihood of lung cancer. In the mist of this lecture, around the time we were examining the hospital practice in legitimizing these drugs, Andrew made a point of how medicine has only really been doing good for society in very recent history. At this point (being that it is a hour and fifteen minute long lecture) my mind began to wonder to one of my favorite shows, Grey’s Anatomy.  I began to think about all the amazing things they do in the show, and how much they help their paients under such harsh work conditions. However, in mist of this day dream, I began to really think about these conditions the characters work under and what really struck out to me was the length of time these doctors were suppose to work. As this thought developed, I began to think about all the mistakes these doctors would make in the show, due to lack of judgment. This though made me begin to wonder if this drama seen in the show was an actual problem in modern medicine?

According to The Harvard Gazette, “more than two thirds of [doctors] reported working shifts longer than 30 consecutive hours”.  These were hours spent directly working with sick or injured patients, hours in which a doctor and or nurse’s lack in judgemnt could mean the difference between a patient living and a patient dying (yes, this is dramatic, but still very plausible).  According to ABC news, “once a doctor worked for more than 17 hours, their performance was effected”.  Along these same lines, a University of Pennsylvania article suggest that “sleep deprivation degrades aspects of neurocognitive performance”.  One could truly spend hours looking up the harms of sleep deprivation and continue to find the same result of how it negatively affects brain function. With this, it can also be a fairly simple assumption that long hours for hospital workers means less sleep , resulting in more errors (exactly what the Harvard Gazette  article was arguing). However, these two arguments can only hold weight if they are combined into one single study.

This is exactly what Health Affairs.org did. This study’s goal was to look at the typical work shift for each nurse, and try to see if there was a correlation between the amount of time each nurse worked and medical errors committed. This study was conducted using a sample size of 396 nurse during 2002, with each of these nurses studied working full time. Each participant of the study had to fill out a journal, recording their work time and sleep patterns, along with breaks and other actions taken through the day.  In concussion, the study found that “data collected on 5,317 work shifts revealed that hospital staff nurses worked longer than scheduled daily, and generally worked more than forty hours per week.” Also, “half shifts worked exceeded ten and a half hours”.  Along with these results, “there were 199 errors and 213 near errors reported during the data gathering”. These errors varied from medication administration to procedural errors to charting errors. While the errors differentiated, the one constant was clear; the longer the shift, the more errors were seen. Another very similar Study showed not only did long hours result in more errors, but also in a greater risk of patient dissatisfaction with their hospital stay.

The conclusion taken from both these study’s supports the claim that long work hours will result in less effective work staff in hospitals. Further study must be conducted in order to eliminate certain third variables, such as the severity of the illness or injury each patient has. This could result in more errors that a more simple diagnosis.

What is clear from these studies is that there is a correlation between sleep/ work hours and errors observed, which might make you want to question your nurse  the next time you find yourself in a hospital.